The International Headache Society describes cluster headaches this way: "Attacks of severe, strictly unilateral pain which is orbital, supraorbital, temporal or in any combination of these sites, lasting 15–180 minutes and occurring from once every other day to 8 times a day. The attacks are associated with one or more of the following, all of which are ipsilateral: conjunctival injection, lacrimation, nasal congestion, rhinorrhoea, forehead and facial sweating, miosis, ptosis, eyelid edema. Most patients are restless or agitated during an attack."

Cluster headaches are nothing short of monstrous. They affect approximately 5% of the population, more men than women. Cluster headache research doesn't seem very plentiful, perhaps because of the relatively low prevalence. That's small comfort to the sufferers of cluster headaches.

Dr. R. Andrew Sewell and Dr. John H. Halpern, Harvard researchers, are studying the effects of two substances -- psilocybin (found in certain mushrooms) and lysergic acid diethylamide (LSD) -- on cluster headaches. Their work will be published in an upcoming issue of Neurology, the journal of the American Academy of Neurology. In February, Dr. Sewell presented "The Effects Of Psilocybin And LSD On Cluster Headache: A Series Of 53 Cases" at the National Headache Foundation’s Annual Headache Research Summit.

Study objective:
"To describe the use of psilocybin and lysergic acid diethylamide (LSD) for treatment of cluster headache."

Patient selection:
They included all respondents who:

• reported cluster headaches
• had attempted treatment of their cluster headaches with either psilocybin or LSD
• agreed to be contacted for evaluation
• allowed review of their medical records

Measuring the outcome:

• abortive treatment
  • a subjective rating of effective"-- termination of a cluster attack in less than 20 minutes
  • ineffective
• preventive treatment:
  • a subjective rating of effective -- total remission of the cluster period
  • partially effective -- cluster attack frequency or intensity diminished
  • ineffective -- subsequent cluster period occurred at the expected time

Study results:
Of the 53 participants:

• 52 had used psilocybin to treat their cluster headaches.
• 9 had used LSD to treat their cluster headaches.
• 22 (85%) who had used psilocybin reported that it had aborted attacks.
• 25 (52%) of the psilocybin users and 7 (88%) of 8 who had used LSD reported termination of at least one cluster period.
• 18 (95%) of 19 psilocybin users and 4 (80%) of 5 LSD users reported extension of their remission periods.
• 22 (42%) psilocybin users and 2 (22%) LSD users found therapeutic effects with sub-hallucinogenic doses.
• In secondary analysis, 76 (52%) respondents reported that psilocybin terminated at least one cluster period.

Study conclusions:
"Our observations suggest that psilocybin and LSD may be effective in treating cluster attacks, possibly by a mechanism that is unrelated to their hallucinogenic properties. This report should not be misinterpreted as an endorsement of the use of illegal substances for self-treatment of cluster headaches."

Some of the greatest discoveries in medicine have occurred by accident. It's not at all unusual for some of the most effective medications for a condition to actually be medications originally developed for another condition then coincidentally discovered to be helpful for others. For example, we have not a single medication for Migraine prevention that was originally developed for that purpose, yet there are over 100 medications in use for Migraine prevention today. A few are now approved by the FDA for Migraine prevention, but the vast majority are still prescribed off-label.

This study runs along those lines with one major exception -- both psilocybin and LSD are Schedule I drugs. It is illegal to manufacture, sell, or possess them. The DEA describes Schedule I drugs thusly, "Substance has a high potential for abuse, has no medical use in the U.S., and has a lack of accepted safety for use under medical supervision." Dr. Sewell and Dr. Halpern did not provide the study participants with psilocybin or LSD. The participants were cluster headache sufferers who had not found relief in "standard" medications and had turned to "magic mushrooms" and LSD out of desperation. Although the results of this trial warrant further study, the politicization of the "war on drugs" makes it unlikely that it will occur any time soon. The pure spirit of the war on drugs is true and good, but the politicized spirit of it claims legitimate patients as victims. One can only hope that those who can change this will come to their senses.

If you want to know more about how cluster headache sufferers are working to help themselves, please visit ClusterBusters.

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Resources:

International Headache Society, “The International Classification of Headache Disorders, Second Edition.” Cephalalgia: An International Journal of Headache, Vol. 24, Supplement 1, 2004.

Sewell, R. Andrew, M.D.; Halpern, John M., M.D. "The Effects Of Psilocybin And LSD On Cluster Headache: A Series Of 53 Cases." Abstract. Presented to the National Headache Foundation’s Annual Headache Research Summit. February, 2006.

Published April 26, 2006
© Teri Robert